Floyd, a 66 year old man reports to his physician that he has had trouble urinat

Question

Floyd, a 66 year old man reports to his physician that he has had trouble urinating for the last several months, with narrowed stream and difficult initiating urination. For the last two days, urination has become more frequent, painful, and produces only small amounts of urine. Urinalysis results are within normal limits, with the exception of the presence of bacteria on culturing. Other observations and lab tests are the following: Digital rectal exam: enlarged prostate and rock hard prostatic nodule in one lobe transrectal ultrasonography: confirms abnormal mass present. Urine culture: bacteria present. Prostate- specific antigen: 12 my/mL. What are the two likely diagnoses? Explain your answers. Why is it difficult for Floyd to urinate? Be sure to describe male functional anatomy when providing an answer. Floyd, a 66 year old man reports to his physician that he has had trouble urinating for the last several months, with narrowed stream and difficult initiating urination. For the last two days, urination has become more frequent, painful, and produces only small amounts of urine. Urinalysis results are within normal limits, with the exception of the presence of bacteria on culturing. Other observations and lab tests are the following: Digital rectal exam: enlarged prostate and rock hard prostatic nodule in one lobe transrectal ultrasonography: confirms abnormal mass present. Urine culture: bacteria present. Prostate- specific antigen: 12 my/mL. What are the two likely diagnoses? Explain your answers. Why is it difficult for Floyd to urinate? Be sure to describe male functional anatomy when providing an answer.

Explanation / Answer

The two likely diagnosis is:

Prostate gland surrounds the urethra. Due to enlargement of prostate due to hyperplasia, prostate gland puts pressure inwards towards the urethra due to which urethra gets narrow and urine does not flow freely through it. The urine flowing through the urethra keeps on decreasing due to which urinary bladder never gets emptied completely. As the passage of urine through urethra gets hampered this leads to difficulty in urination, imcomplete urination, increased frequency of urination. The presence of urine in urinary bladder gives rise to growth of bacteria due to which urinary tract infection happens. As in this case urine culture shows presence of bacteria, it indicates urinary tract infection.

When prostatic hyperplasia is beningn then in that case prostate texture is smooth but in this case there is rock hard prostatic nodule in one lobe which indicates prostate cancer. Moreover Prostate specific antigen (PSA) is 12 which is more than normal levels of 4. The high levels of PSA also confirms prostate cancer.

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